The use of relaxation techniques to reduce nurses’ anxiety levels during COVID-19 Pandemic
Abstract
Background: As a result of the increased number of Corona Virus Disease 2019 (COVID-19) cases in Indonesia in 2021, nurses as one of the front-liners have experienced extreme workload and stress. This has caused increased numbers of mental health problems in nurses. One of the most common problems is anxiety. Objective: This study aimed to measure the effectiveness of relaxation techniques to reduce nurses’ anxiety levels during COVID-19 pandemic. Methods: This is a quantitative study, using pre- and post- test design. Nurses’ anxiety levels were measured before and after the application of relaxation techniques, namely breathing, progressive muscle relaxation and guided imagery. A training was provided for the participants, along with module and a music video to guide their practices. Results: The application of relaxation technique for approximately two weeks after an online training significantly reduced nurses’ anxiety levels. The score of anxiety levels has significantly decreased from pre- (M= 56.51, SD= 15.80) to (M= 48.30, SD= 13.70) post- training and application, t(201) = 5.82, p < .001 (two-tailed). Conclusion: It is important to provide nurses with support that they need during pandemic or any other catastrophic events, in order to maintain their safety and well-being.
References
2. Huang Y, Zhao, N. Mental health burden for the public affected by the COVID-19 outbreak in China: who will be the high-risk group? Psychol Health Med. 2021;26(1):23-34.
3. Lai JMS, Wang Y, Cai Z, Hu J, Wei N, Wu J, Du H, Chen T, Li R. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw. 2020;3(3).
4. Lu W, Wang, H., Lin, Y., Li, L., Jun. Psychological status of medical workforce during the COVID-19 pandemic: a cross-sectional study. Psychiatry Res 2020;288:112936-.
5. Tan BYQC, Nicholas W S ; Lee, Grace K H ; Jing, Mingxue ; Goh, Yihui ; Yeo, Leonard L L ; Zhang, Ka ; Chin, Howe-Keat ; Ahmad, Aftab ; Khan, Faheem Ahmed ; Shanmugam, Ganesh Napolean ; Chan, Bernard P L ; Sunny, Sibi ; Chandra, Bharatendu ; Ong, Jonathan J Y ; Paliwal, Prakash R ; Wong, Lily Y H ; Sagayanathan, Renarebecca ; Chen, Jin Tao ; Ng, Alison Ying Ying ; Teoh, Hock Luen ; Ho, Cyrus S ; Ho, Roger C ; Sharma, Vijay K. Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Singapore. Annals of internal medicine. 2020;173(4):317-20.
6. Wu YW, Jun ; Luo, Chenggang ; Hu, Sheng ; Lin, Xi ; Anderson, Aimee E. ; Bruera, Eduardo ; Yang, Xiaoxin ; Wei, Shaozhong ; Qian, Yu. A Comparison of Burnout Frequency Among Oncology Physicians and Nurses Working on the Frontline and Usual Wards During the COVID-19 Epidemic in Wuhan, China. Journal of pain and symptom management. 2020;60(1):e60-e5.
7. Ignjatovic Ristic DH, Darko ; Bankovic, Dragic ; KoAovic, Aleksandar ; Ristic, Ivan ; Rosic, Gvozden ; Ristic, Branko ; Milovanovic, Dragan ; Janjic, Vladimir ; Jovanovic, Mirjana ; Selakovic, Dragica ; JoviAic, Milena ; Stevanovic, NebojA a ; Milanovic, Pavle ; Milenkovic, Nemanja ; Paunovic, Milan ; StaA evic KarliAic, Ivana ; Novakovic, Ivona ; Aleksic, Jelena ; DraA kovic, Marija ; Randelovic, Nevena ; Aordic, Milan ; Gavrilovic, Jagoda. Levels of stress and resilience related to the COVID‐19 pandemic among academic medical staff in Serbia. Psychiatry and clinical neurosciences. 2020;74(11):604-5.
8. Pourteimour SY, Safura ; Babamohamadi, Hassan. The relationship between mental workload and job performance among Iranian nurses providing care to COVID‐19 patients: A cross‐sectional study. Journal of nursing management. 2021;29(6):1723-32.
9. Townsend MdM, KI Psychiatric Mental Health Nursing: concepts of care in evidence-based practice,. Philadelphia: FA Davis Company; 2018.
10. Shives L. Basic Concepts of Psychiatric-Mental Health Nursing. Philadelphia: Wolters Kluwer; 2012.
11. Liu KC, Ying ; Wu, Duozhi ; Lin, Ruzheng ; Wang, Zaisheng ; Pan, Liqing. Effects of progressive muscle relaxation on anxiety and sleep quality in patients with COVID-19. Complementary therapies in clinical practice. 2020;39:101132-.
12. Wang JL, Jie ; Li, Ling ; Man, Jing ; Yue, Shihong ; Liu, Zhaojun. Effect of education and muscle relaxation program on anxiety, depression and care burden in caregivers of acute stroke survivors: A randomized, controlled study. Medicine (Baltimore). 2021;100(4):e24154-e.
13. Kılıç ZK, Songül ; Tutar, Nuri. The Effect of Progressive Relaxation Exercises on Dyspnea and Anxiety Levels in Individuals With COPD: A Randomized Controlled Trial. Holistic nursing practice. 2023;37(1):E14-E23.
14. Eroglu H, Gok Metin Z. Benson Relaxation Technique Combined With Music Therapy for Fatigue, Anxiety, and Depression in Hemodialysis Patients: A Randomized Controlled Trial. Holistic Nursing Practice. 2022;36(3):139-48.
15. Padminee KH, R ; Shankar, Paulindraraj ; Senthil, D ; Jayakaran, Trophimus Gnanabagyan ; Kabita, Sahoo. Effectiveness of biofeedback relaxation and audio‐visual distraction on dental anxiety among 7‐ to 12‐year‐old children while administering local anaesthesia: A randomized clinical trial. International journal of paediatric dentistry. 2022;32(1):31-40.
16. Abu Maloh HIAS, Kim Lam ; AbuRuz, Mohannad Eid ; Chong, Seng Choi ; Ismail, Siti Irma Fadhilah ; Soh, Kim Geok ; Abu Maloh, Dima Ibrahim. Efficacy of Benson’s Relaxation Technique on Anxiety and Depression among Patients Undergoing Hemodialysis: A Systematic Review. Clinical Nursing Research. 2022;31(1):122-35.
17. Olbrecht VAOC, Keith T. ; Williams, Sara E. ; Boehmer, Chloe O. ; Marchant, Gilbert W. ; Glynn, Susan M. ; Geisler, Kristie J. ; Ding, Lili ; Yang, Gang ; King, Christopher D. Guided relaxation–based virtual reality for acute postoperative pain and anxiety in a pediatric population: pilot observational study. Journal of medical Internet research. 2021;23(7):e26328-e.
18. Vagnoli LB, Alessandra ; Amore, Elena ; De Masi, Salvatore ; Messeri, Andrea. Relaxation-guided imagery reduces perioperative anxiety and pain in children: a randomized study. European journal of pediatrics. 2019;178(6):913-21.
19. MCCC. SIKEVID: Senarai Kecemasan Diri Masa Pandemi COVID-19. Yogyakarta: MCCC; 2020.
20. de Pinho LGS, F.; Sequeira, C.; Teixeira, L.; Fonseca, C.; Lopes, M.J. Portuguese Nurses’ Stress, Anxiety, and Depression Reduction Strategies during the COVID-19 Outbreak. Int J Environ Res Public Health. 2021;18(7):3490.
21. Mo YD, Lan ; Zhang, Liyan ; Lang, Qiuyan ; Pang, He ; Liao, Chunyan ; Wang, Nannan ; Tao, Pinyue ; Huang, Huiqiao. Anxiety of Nurses to support Wuhan in fighting against COVID‐19 Epidemic and its Correlation With Work Stress and Self‐efficacy. Journal of clinical nursing. 2021;30(3-4):397-405.
22. Leodoro J. Labrague JAADlSR. COVID-19 anxiety among front-line nurses: Predictive role of organisational support, personal resilience and social support. Journal of Nursing Management. 2020;28(7):1653-61.
23. Qing-Qing Wang Y-YF, Hao-Lian Huang, Wen-Jun Lv, Xiao-Xiao Wang, Tian-Ting Yang, Jing-Mei Yuan, Ying Gao, Rui-Lian Qian, Yan-Hong Zhang. Anxiety, depression and cognitive emotion regulation strategies in Chinese nurses during the COVID-19 outbreak. Journal of Nursing Management. 2021;29(5):1263-74.
24. Valentina Simonetti AD, Rossella Ambrosca, Paola Arcadi, Giusi Graziano, Gianluca Pucciarelli, Silvio Simeone, Ercole Vellone, Rosaria Alvaro, Giancarlo Cicolini. Anxiety, sleep disorders and self-efficacy among nurses during COVID-19 pandemic: A large cross-sectional study. Journal of Clinical Nursing. 2021;30(9-10):1360-71.
25. Amy Witkoski Stimpfel LG, Lloyd Goldsamt, Jessie Zhanay, Victoria Vaughan Dickson. The Psychosocial Impact of COVID-19 on Registered Nurses. Health Services Research. 2021;56(S2):47-8.
26. Roberts NJM-K, K. ; Lippiett, K. ; Ray, E. ; Welch, L. ; Kelly, C. Levels of resilience, anxiety and depression in nurses working in respiratory clinical areas during the COVID pandemic. Respiratory medicine. 2021;176:106219-.
27. Tamrakar P, Pant SB, Acharya SP. Anxiety and depression among nurses in COVID and non-COVID intensive care units. Nursing in Critical Care. 2021;28(2).
28. Liu Y, Jiang, T, Shi, T, Liu, Y, Liu, X, Xu, G, Li, F, Wang, Y and Wu, X The effectiveness of diaphragmatic breathing relaxation training for improving sleep quality among nursing staff during the COVID-19 outbreak: a before and after study. Sleep Medicine. 2021;78:8-14.
29. Samaneh Ganjeali ZF, Seyedeh Azam Sajadi, Kourosh Zarea. The effect of the demonstration-based progressive muscle relaxation technique
on stress and anxiety in nurses caring
for COVID-19 patients: a randomized clinical trial. BMC Psychiatry. 2022;22(791).
30. JM S. Music research in medical/dental treatment: meta-analysis and clinical applications. J Music Ther. 1986;23(2):56-122.
31. Nazia Mustafa MF, Shoaib Kiani, Sana Khan, Noor Ul Ain and Jaweria Mumtaz. Comparison of progressive muscular relaxation (pmr) and music therapy (mt) in reducing the anxiety, depression and stress symptoms among nurses. Pakistan Armed Forces Medical Journa. 2021;71(6).
32. Labrague LJS, Janet Alexis A. Fear of COVID‐19, psychological distress, work satisfaction and turnover intention among frontline nurses. Journal of nursing management. 2021;29(3):395-403.
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